Introduction: Traumatic diaphragmatic rupture is an uncommon injury and occurs more frequently on the left side. Right-sided rupture is rare because the liver protects the diaphragm from traumatic forces. However, when a right-sided defect occurs, hepatic herniation may cause respiratory compromise and liver dysfunction. We report a rare case of right-sided traumatic diaphragmatic rupture with hepatic herniation successfully treated by laparoscopic repair.

Case: A patient presented with progressive respiratory failure and worsening liver dysfunction following trauma. Computed tomography revealed herniation of the right hepatic lobe through a right-sided diaphragmatic defect. Based on these findings, surgical repair was performed.

Surgical Procedure: Laparoscopic exploration revealed herniation of the right hepatic lobe through an approximately 8-cm diaphragmatic defect. The herniated liver was carefully reduced into the abdominal cavity. The defect was closed with interrupted non-absorbable sutures under laparoscopic visualization.

Outcomes: The operation time was 3 hours and 5 minutes, with minimal blood loss. The postoperative course was uneventful. The patient was transferred to the orthopedic department on postoperative day 17.

Discussion: Hepatic herniation through a right-sided diaphragmatic defect may cause hepatic congestion and respiratory compromise. In this case, progressive respiratory failure and worsening liver dysfunction prompted surgical intervention. Laparoscopic repair provides excellent visualization and reduced surgical invasiveness, allowing safe reduction of the herniated liver and secure closure of the defect.

Conclusion: Laparoscopic repair may be a safe and effective treatment option for selected patients with right-sided traumatic diaphragmatic rupture with hepatic herniation.